Endocrine Abstracts

Introduction

The aim of the present study was to determine the possible factors contributing to the development of hypothyrodisim in patients who had a subacute thyroiditis (SAT) attack.

Methods

Medical records of patients who were diagnosed with SAT between September 2014 and January 2020 were analyzed retrospectively in one center in Trabzon city of Turkey. The medical records of the patients were searched with ICD-10 code E06.1. There were 283 patients recorded with ICD-10 code E06.1; 119 of them had appropriate records and enough data to be involved into the study. Patients known to have previous thyroid disease were excluded. Patients who were followed at least 6 months after SAT attack cured were included. The demographic data of the patients; laboratory results including erythrocyte sedimentation rate (ESR), C reactive protein (CRP), thyroid stimulating hormone (TSH), triiyodotronine (T3), thyroxine (T4), anti-thyroid antibodies; the character and spread of neck pain; ultrasonography (USG) findings; the medications; the need to steroid therapy and the duration of steroid therapy; presence of hypothyroidism; occurrence and frequency of recurrences were recorded. The relationship between these parameters and development of permanent hypothyroidism were searched.

Results

The mean age of the patients was 42.3 ± 10.9 (24–78 year). The frequency of SAT was higher among women than men (93 women vs 26 men; 78.2% vs 21.8%, respectively). SAT was more frequent during spring and summer, but there were no statistical differences in means of the months or the seasons (P= 0.329, 0.534, respectively). Eighty-eight (69.7%) of the patients described a viral/flu-like disease before neck pain started. Almost half of the patients (n = 68, 57.1%) had gone to a different specialty other than endocrinology; 55 (46.2%) to otorhinolaryngology, 10 (8.4%) to internal medicine, 2 (0.02%) to emergency clinic and 1 (0.01%) to infectious disease until taking a SAT diagnosis. Thirty-four (28.6%) of the patients had been prescribed antibiotics for misdiagnosis of an upper tract infection. There were 10 patients (8.4%) who developed hypothyroidism after SAT attack. Mean steroid using time was longer at patients with hypothyroidism (17.7/16.4 vs. 8.9/5.9 weeks; P = 0.021). Hypothyroidism was more frequent among patients who did not have thyrotoxicosis during SAT attack; p= 0.004 and who had recurrent SAT attacks p= 0.035.

Conclusions

Patients who need steroid for a longer period, who have recurrent SAT attacks and who did not have thyrotoxicosis during SAT attacks should be closely monitored in means of developing hypothyroidism.